Is Your Back Pain All In Your Head?

Understandably, pain may make us angry. But does the way we cope with anger lead us to experience more pain?

Low back pain is the leading cause of disability worldwide, affecting millions of people. In thinking about ways to treat people suffering with this debilitating condition, focusing on the mind-body connection might offer new hope.

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My client, who I’ll refer to as Shari, presented in treatment to learn mindfulness to help her manage her chronic back pain stemming from a gymnastics injury as a teenager. When she began therapy, she explained she’d been in treatment before and wanted to focus exclusively on her pain, not her past. She enthusiastically tried breathing exercises and approaching her pain in a new way. Instead of grimacing, she tried to notice and accept pain and learned to breathe deeper both in moments of pain, and throughout the day. I really admired Shari’s focus on trying to use tools to improve her quality of life.

One day, Shari mentioned she was livid with her mother and found herself in a screaming match with her earlier in the day. That same day, her pain was more palpable. Initially reluctant, Shari eventually was willing to experiment with tracking her pain and anger and noticing how the two experiences correlated.

While chronic pain is not caused by anger or resulting muscle tension, stress may maintain or exacerbate existing pain. Working on managing your irritability may prove useful in improving your overall well-being. In a study of women with fibromyalgia, inhibiting anger predicted greater pain. In other words, putting on a happy face is literally a pain.

According to research by Dr. John Burns at Rush University Medical Center, pushing away anger doesn’t lead to relief, it leads to more suffering. In a study, Burns and his colleagues looked at chronic low back pain among participants in an experiment. The participants were asked to work on a computer maze while being interrupted by an annoying presence and instructed not show any signs of anger or talk about how they felt. In a second condition, participants were able to talk about their frustrations. The researchers looked at muscle tension, blood pressure, and heart rate. Interestingly, suppression was associated with higher levels of muscle tension and pain.

If you struggle with pain and anger, in addition to learning to cope with your pain, you might also consider thinking through emotionally intelligent ways to manage anger. Here are a few tips to consider:

1. Notice your emotions.
The first step toward managing emotions is taking a moment to notice what you are feeling and how intensely you experience the emotion. It’s hard to manage an emotion like anger without taking note of it. For example, if you notice you are angry, try to rank your anger on a scale of 0 (least angry) to 10 (most angry).

2. Notice your thoughts.
Often, we habitually believe anything and everything that we think. If you feel angry based on a potentially faulty interpretation, you might manage how you feel by changing what you think. If your anger stems from the conclusion that your boss deliberately omitted to thank you after a big presentation, you might take a moment to consider other possible explanations for the oversight. Possibly concluding, “She was stressed and mindless,” as opposed to, “This is an abusive work environment.” Giving the benefit of the doubt is hard, but easier than brewing anger.

3. Talk about how you feel.
When you’re angry for good reason, instead of holding it in your body, come up with an emotionally intelligent way to communicate your feelings. For example, you might wait for your anger to quell, noting you’re especially vulnerable because you’re exhausted. Then you might approach your boss and let her know that while you know she had a busy week, you hope that in the future she might credit your work in her presentation. Talking about your feelings might help reduce your pain and also prove useful in the long-term.